Community Health Planning

• Planning involves logical decision-making to address health concerns, determining necessary actions, and setting community interventions.

Priority Setting

• The WHO criteria includes: -Problem Significance -Community Awareness -Ability to Reduce Risk -Cost of Reducing Risk -Identifying the Target Population -Availability of Resources
• Community health problems are identified, listed, and treated separately using a set of criteria that is agreed upon by the group and suggested by WHO.

Formulating Goals and Objectives

• Goals are desired outcomes at the end of interventions
• Objectives are short-term changes in the community achieved through the health team and community working together.
• Objectives should be Specific, Measurable, Attainable, Relevant, and Time-bound (SMART).

Community Interventions

• Effective interventions in one community may not work in another.
• Groups analyze the reasons behind health behaviors and develop strategies to address underlying causes.
• An example of this is that if people choose home delivery over facility-based delivery due to cost or lack of access, then strategies focus on improving facility-based services to improve facility-based deliveries

Implementing Intervention

• The action phase involves dealing with recognized priority health concerns that are exciting
• This enhances the community's capability in dealing with common health conditions/problems
• It requires common understanding of goals, objectives, and planned interventions among members of the implementing group.
• Nurses facilitate the process instead of directly implementing interventions.

Community Organizing (CO)

• A process of steps/activities that build people's self-confidence in their collective strength and capabilities (Manalili, 1990).
• It educates and mobilizes community members to resolve community problems.
• Teaching the community to apply the nursing process on its own that allows it to be an active participant rather than a passive recipient.
• CO is a social development approach that transforms the individualistic, powerless, and voiceless poor into dynamic, participatory, politically responsive communities.
• Characteristics of CO are transformative and collective.

Goals of CO

• People empowerment
• Development of self-reliant community
• Improved quality of life (UST,NSTP,20120)
• Building social structures for institutionalizing power
• Building alliances/networking to have a voice for strong advocacy
• Social transformation

Core Principles in Community Organizing

• Community organizing is people-centered -People are the means and ends of development, and community empowerment is the process and outcome (Felix, 1998)
• Community organizing is participative -The community must participate in the entire process, including assessment, planning, implementation, and evaluation
• Community organizing is democratic
• It allows the majority to recognize and analyze difficulties and articulate aspirations.
• CO should empower the disadvantaged population.
• Community organizing is developmental --CO should be directed at changing current undesirable conditions
• Community organizing is process-oriented
• -The community organizing goals of empowerment and development are achieved through a process of change
• Organizers need to diligently and patiently follow the community organizing process to achieve its goals

Phases of Community Organizing

• Pre-entry --Involves preparation by the organizer and choosing a community for partnership.
• This includes knowing the goals of the CO activity, delineating criteria for site selection, and making a list of information sources
• Proper selection is crucial
• -The identification of barriers, threats, strengths, and opportunities at this stage is an important determinant of the overall outcome of CO.

Identifying Communities

• Initial surveys
• Review of health facilities
• Reviews of barangay/municipal profile
• Referrals from other communities/institutions
• Consultations from LGU or private institutions
• Entry phase -Formalizes the start of the organizing process
• Organizers get to know the community
• Courteously call local formal leaders
• Visit informal leader

Community Integration

• Involves integration with the people, termed as "pakikipamuhay,
• Establishing rapport involves: --Living with them -Undergoing the same experience as they do -Sharing their aspirations and hardships

Integration Styles

• CO objectives aim to understand people's culture, history, economy, leaders, and lifestyle
• Manalili, (1990) describes integration styles:
• "Now you see, now you don't" style, where the organizer visits the community based on a schedule but cannot transcend the "guest" status and it cannot break down the barriers
• "Boarder" style involves renting a room/house in the village but not sharing life with the community; the organizer is seen as the guest.
• “Elitist” style is when the organizer lives with the barangay chairman or another prominent person as it makes integration more ______.

Integration Activities

• Starting where the people are,
• Doing house-to-house visits
• Seeking out and converse with many people
• Lending a hand in household chores
• Participating in social activities and direct livelihood production
• In short, “IMMERSION”

People-Centered Approach

• Pagbabahay-bahay involves occasional home visits for developing a close relationship
• Huntahan is informal conversation
• Participation in the production process includes the organizer participates in livelihood activities
• Participation in social activities helping the organizer and people know

Social Analysis

• A process of gathering, collating, and analyzing data.
• It is to gain an understanding of community conditions -Help in problem identification and determining root causes.
• Involves a systematic learning and analyzing of structures and forces in the community -Including socio-political, economic, cultural spiritual, environment, and gender dimensions
• Addresses immediate and long-term problems and issues.
• Social analysis is also referred to as social investigation, community study/analysis, community needs assessment and Community Dx.

Identifying Potential Leaders

• Characteristics include representing the target group -Possessing/displaying leadership qualities
• Trust and confidence of the community Expressing belief in changing undesirable situations and a willingness to invest time.
• Forming a single core group is suggested
• -The first group may decide to have separate groups.
• The process of bringing together the advanced indigenous leaders identified during the social investigation stages. -CO objectives are for ensuring the ___

Community Organization

• Conducts assembly with understanding community concerns and plan of action
• If the community decides to formalize, it must have the following characteristics
• -An organizational name and structure
• Officers are to be recognized by the ___

Implementing the Plans

• The action/mobilization phase refers to the implementation of community’s planned programs and projects
• The phase constitutes actual action-taking to address and resolve community issues/concerns.

Evaluation

• Systematic, critical analysis of the current state of the organization or projects.
• Comparison against desired or planned goals/objectives.
• Lessons are drawn out from the activity.
• The people should sit down and review the outcomes, whether good or bad.
• Considerations are preparation, the right contact persons and strengths?

Exit and Expansion phase

• Occurs when indicators of success are met -Indicators include high levels of socio-political awareness, sustained participation, active leaders, clear plans, and community-set goals
• Readiness for exit is marked by the attainment of set goals and the demonstration of the capacity to lead the community in dealing with common ___.

COPAR

• A community development approach for allowing participatory action.
  • Systematically analyzes the situation/ (research) and plan solution
• Implements project/programs (utilizing Community ___.

Additional Factors

• Built environment.
• Proper Excreta Disposal
• Food Safety Sanitation
• Vermin and Vector Control

Monitoring and Evaluating Community Health

• Evaluation approaches are focused on: -Structure -Process -Outcome
• Structure Evaluation involves looking into the manpower and physical resources of the agency responsible for the community health interventions.
• Process evaluation: Examining the manner of undergoing assessment, diagnosis, planning, implementation and evaluation was undertaken.
• Outcome evaluation: Determining the degree of attainment of goals and objectives.

Types of Evaluation

• Formative evaluation: Judgement about the effectiveness of nursing interventions as they are implemented.
• This is ongoing and continuous while family nursing care is implemented and family nurse interactions are taking place
• Summative Evaluation: Determining the end results of family nursing care and usually involves measuring outcomes (Maurer and Smith, 2009).

Family Health Records

• Putting all records related to family members in a single folder.
• This gives a total picture of the services and helps give effective, economic service to the family.
• Separate record forms for different services like TB and maternity.
• Consolidate all individual records into one single folder.

Community Profile

• Shows a summary of baseline conditions and trends in the community and an established study area.
• Establishes context for assessing potential impacts.
• Developing it involves identifying community issues and attitudes, locating notable features in the study area, and assessing social and economic implications.
• Information comes from primary interviews and secondary comprehensive plans and newspaper articles